Enhanced recovery ERAS for elderly: a safe and beneficial pathway in colorectal surgery.

Details

Serval ID
serval:BIB_134FF9720C5C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Enhanced recovery ERAS for elderly: a safe and beneficial pathway in colorectal surgery.
Journal
International journal of colorectal disease
Author(s)
Slieker J., Frauche P., Jurt J., Addor V., Blanc C., Demartines N., Hübner M.
ISSN
1432-1262 (Electronic)
ISSN-L
0179-1958
Publication state
Published
Issued date
02/2017
Peer-reviewed
Oui
Volume
32
Number
2
Pages
215-221
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Enhanced recovery after surgery (ERAS) pathway includes recovery goals requiring active participation of the patients; this may be perceived as "aggressive" care in older patients. The aim of the present study was to assess whether ERAS was feasible and beneficial in older patients.
Since June 2011, all consecutive colorectal patients were included in an ERAS pathway and documented in a dedicated prospective database. This retrospective analysis included 513 patients, 311 younger patients (<70 years) and 202 older patients (≥70 years). Outcomes were adherence to the ERAS pathway, functional recovery, postoperative complications, and hospital stay.
Older patients had significantly more diabetes, malignancies, cardiac, and respiratory co-morbidities; both groups underwent similar surgical procedures. Overall adherence to the ERAS pathway was in median 78 % in younger and 74 % in older patients (P = 0.86). In older patients, urinary drains were kept longer (P = 0.001), and oral fluid intake was reduced from day 0 to day 3 (P < 0.001). There were no differences in mobilization and intake of nutritional supplements. Postoperative complications were similar for both comparative groups (51.5 vs. 46.6 %, P = 0.32). Median length of stay was 7 days (IQR 5-13) in older patients vs. 6 days (IQR 4-10) in the younger group (P = 0.001).
Adherence to the ERAS pathway was equally high in older patients. Despite more co-morbidities, older patients did not experience more complications. Recovery was similar and hospital stay was only 1 day longer than in younger patients. ERAS pathway is of value for all patients and does not need any adaptation for the elderly.

Keywords
Aged, Aged, 80 and over, Colorectal Surgery, Critical Pathways, Demography, Humans, Length of Stay, Middle Aged, Patient Compliance, Postoperative Complications/etiology, Recovery of Function
Pubmed
Create date
15/02/2017 20:39
Last modification date
20/08/2019 13:41
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